Plaque in any artery can appear as simple simply visualized narrowing of the vessel or isoechoic atheroma. Calcification causes characteristic shadowing deep to the lesion and color flow can help qualify the degree of narrowing. In skilled hands, pre- and post-obstruction flow velocity can determine percent obstruction.
this is a scan using the linear transducer on a vascular preset here we're lined up against the carotid artery that what we see here is a sharp line of the intimal walls but this discontinuity here represents calcified plaque on the posterior wall and you can see the shadowing coming down from the black preventing the visualization of that posterior wall of the carotid artery on the same scan by adding color now as we play it we can see there's actually luminal narrowing as the blood is progressing towards the brain from this calcified plaque here creating narrowing within the artery itself you
